{config_load file="$language/lang.conf" section="create_account"}
<div class="mod_news">
<table width="100%" cellpadding="0" cellspacing="0">
<tr><td class="mod_blueleft"></td><td class="mod_bluecenter">
<div class="modtit_acnt">{#heading_create_account#}</div>
</td><td class="mod_blueright"></td></tr></table>
{if $error!=''}
<div class="error">{$error}</div>
{/if}
{$FORM_ACTION}
<div class="mod_space">
<div class="mod_corner">
<table width="100%" border="0" cellspacing="0" cellpadding="0">
  <tr>
    <td class="mod_th">{#title_personal#}</td>
    <td><span class="red right">{#text_must#}</span></td>
  </tr>
{if $gender=='1'}
  <tr>
    <td class="mod_tdb"><label for="gender" title="{$ENTRY_GENDER_ERROR}">{#text_gender#}</label></td>
    <td class="mod_td2">{$INPUT_MALE}<br />{$INPUT_FEMALE}</td>
  </tr>
  {/if}
  <tr>
    <td class="mod_tdb"><label for="firstname" title="{$ENTRY_FIRST_NAME_ERROR}">{#text_firstname#}</label></td>
    <td class="mod_td2">{$INPUT_FIRSTNAME}</td>
  </tr>
{if $secondname=='1'}
  <tr>
    <td class="mod_tdb">{#text_secondname#}</td>
    <td class="mod_td2">{$INPUT_SECONDNAME}</td>
  </tr>
  {/if}
  <tr>
    <td class="mod_tdb"><label for="lastname" title="{$ENTRY_LAST_NAME_ERROR}">{#text_lastname#}</label></td>
    <td class="mod_td2">{$INPUT_LASTNAME}</td>
  </tr>
  {if $birthdate=='1'}
  <tr>
    <td class="mod_tdb"><label for="dob" title="{$ENTRY_DATE_OF_BIRTH_ERROR}">{#text_birthdate#}</label></td>
    <td class="mod_td2">{$INPUT_DOB}</td>
  </tr>
  {/if}
  <tr>
    <td class="mod_tdb"><label for="email" title="{$ENTRY_EMAIL_ADDRESS_ERROR}">{#text_email#}</label></td>
    <td class="mod_td2">{$INPUT_EMAIL}</td>
  </tr>
  {if $company=='1'}
  <tr>
    <td class="mod_th" colspan="2">{#title_company#}</td>
  </tr>
  <tr>
    <td class="mod_tdb">{#text_company#}</td>
    <td class="mod_td2">{$INPUT_COMPANY}</td>
  </tr>
  {if $vat=='1'}
  <tr>
     <td class="mod_tdb">{#text_ustid#}</td>
     <td class="mod_td2">{$INPUT_VAT}</td>
  </tr>
  {/if}
  {/if}
  {if $street_address=='1'}
  <tr>
    <td class="mod_th" colspan="2">{#title_address#}</td>
  </tr>
  {/if}
  {if $street_address=='1'}
  <tr>
    <td class="mod_tdb"><label for="address" title="{$ENTRY_STREET_ADDRESS_ERROR}">{#text_street#}</label></td>
    <td class="mod_td2">{$INPUT_STREET}</td>
  </tr>
  {/if}
  {if $suburb=='1'}
  <tr>
    <td class="mod_tdb">{#text_suburb#}</td>
    <td class="mod_td2">{$INPUT_SUBURB}</td>
  </tr>
  {/if}
  {if $postcode=='1'}
  <tr>
    <td class="mod_tdb"><label for="postcode" title="{$ENTRY_POST_CODE_ERROR}">{#text_code#}</label></td>
    <td class="mod_td2">{$INPUT_CODE}</td>
  </tr>
  {/if}
  {if $city=='1'}
  <tr>
    <td class="mod_tdb"><label for="city" title="{$ENTRY_CITY_ERROR}">{#text_city#}</label></td>
    <td class="mod_td2">{$INPUT_CITY}</td>
  </tr>
  {/if}
  {if $state=='1'}
  <tr>
    <td class="mod_tdb"><label for="state" title="{$ENTRY_STATE_ERROR_SELECT}">{#text_state#}</label></td>
    <td class="mod_td2"><span id="stateXML">{$INPUT_STATE}</span></td>
  </tr>
  {/if}
  {if $country=='1'}
  <tr>
    <td class="mod_tdb"><label for="country" title="{$ENTRY_COUNTRY_ERROR}">{#text_country#}</label></td>
    <td class="mod_td2">{$SELECT_COUNTRY}{$SELECT_COUNTRY_NOSCRIPT}</td>
  </tr>
  {/if}
  {if $telephone=='1'}
  <tr>
    <td class="mod_th" colspan="2">{#title_contact#}</td>
  </tr>
  {/if}
  {if $telephone=='1'}
  <tr>
    <td class="mod_tdb"><label for="telephone" title="{$ENTRY_TELEPHONE_NUMBER_ERROR}">{#text_tel#}</label></td>
    <td class="mod_td2">{$INPUT_TEL}</td>
  </tr>
  {/if}
  {if $fax=='1'}
  <tr>
    <td class="mod_tdb">{#text_fax#}</td>
    <td class="mod_td2">{$INPUT_FAX}</td>
  </tr>
  {/if}
{if $INPUT_CUSTOMERS_EXTRA_FIELDS}
{foreach item=customers_extra_filelds from=$INPUT_CUSTOMERS_EXTRA_FIELDS}
  <tr>
    <td class="mod_tdb">{$customers_extra_filelds.NAME}:</td>
    <td class="mod_td2">{$customers_extra_filelds.VALUE}</td>
  </tr>
{/foreach}
{/if}
</table>
</div>
<table>
  <tr>
    <td class="mod_tdb"></td>
    <td class="mod_td2">{$BUTTON_SUBMIT}</td>
  </tr>
</table>
</div>
</div>
{$FORM_END}

